I f a patient takes the medication the way it prescribed there is no OD. All opiates will make one dependent if taken long enough. In Mexico they sell tramadol over the counter at all stores. The reason you’re not being taken care of is heroin, fentanyl, people shooting up oxycontin and so on. Those deaths were counted with all others , suicide included. one has to be careful taking opiates but to suffer with chronic pain is barbaric.